Functional Electrical Stimulation (FES) in Neurorehabilitation: Restoring Function Through Innovation
Functional electrical stimulation (FES) is a technology that delivers controlled electrical currents to peripheral motor nerves, triggering muscle contractions that replicate natural movement. It has become a powerful tool in rehabilitating individuals with impaired motor function due to neurological conditions such as spinal cord injury (SCI), stroke, multiple sclerosis (MS) and Parkinson’s.
By stimulating the nerves responsible for movement, FES can restore or assist key functions such as walking, standing, grasping, and even bladder or respiratory control—depending on the placement and programming of the electrodes. These electrical pulses can be administered through surface electrodes or more permanent implanted devices. Not only does FES support functional restoration, but it also promotes therapeutic benefits such as preventing muscle atrophy, improving circulation, and enhancing metabolic and cardiovascular health (1).
FES has been widely applied in stroke and spinal cord rehabilitation with promising outcomes. Systematic reviews and clinical studies indicate that FES can moderately improve motor recovery and quality of life when combined with task-specific training and patient participation (2).
A Brief History and Expanding Clinical Application
FES has been used for over four decades in both clinical and assistive contexts. While it began primarily as a treatment for foot drop in stroke and MS patients, its scope has expanded to upper limb rehabilitation, balance improvement, spasticity management, and gait correction across a broader range of neurological conditions (3).
Today, it’s not uncommon for FES to be integrated into functional retraining programs for activities of daily living. In spinal cord injury cases, FES has shown to preserve musculoskeletal and cardiopulmonary health, which is essential for long-term rehabilitation and independence (4).
In patients with MS, FES has been found to improve gait performance and muscle strength while reducing fatigue. Similarly, those with Parkinson’s disease have experienced reductions in freezing episodes and improved initiation of movement through targeted stimulation protocols (5).
Advancements and the Future of FES
Recent developments have focused on adaptive and closed-loop FES systems—technologies that adjust in real time to user feedback or sensor data to promote more physiological movement. When combined with brain-computer interfaces (BCIs), FES opens the door to highly integrated neuroprosthetic systems that mimic the natural motor intent of the user (6).
These innovations help reinforce neuroplasticity—rewiring the brain’s connections through repetitive and purposeful motion. Closed-loop FES has the potential to further enhance outcomes by delivering stimulation precisely when needed during a movement, making rehabilitation both efficient and intuitive (7).
As researchers continue to refine stimulation parameters and integrate wearable and AI-driven systems, FES remains a cornerstone of modern neurorehabilitation. With an eye toward maximizing independence and recovery, it is increasingly recognised not just as a therapy—but as a technological partner in rebuilding lives after neurological injury (8).
References
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Kanojiya DJ, Jagad K. Functional Electrical Stimulation for Physiotherapy Rehabilitation. Int J Sci Healthc Res. 2021.
Peckham PH, Knutson JS. Functional electrical stimulation for neuromuscular applications. Annu Rev Biomed Eng. 2005.
Scano A, Mira RM, Gabbrielli G, Molinari F. Whole-Body Adaptive Functional Electrical Stimulation Kinesiotherapy. Sensors (Basel). 2022.
Sujith OK. Functional electrical stimulation in neurological disorders. Eur J Neurol. 2008.
Milosevic M, Marquez-Chin C, Masani K. Why brain-controlled neuroprosthetics matter. Biomed Eng Online. 2020.
Arsenidis A, Moraitopoulos A, et al. Novel functional electrical stimulation parameters for improved rehabilitation. Glob Clin Eng J. 2024.
Rupp R. Functional Electrical Stimulation. In: Neuroprosthetics and Brain-Computer Interfaces Handbook. 2021.